Experience Of Death Research Articles

The impact of patient death experiences early in training on resident physicians: a qualitative study.

Patient death is an inevitability during medical training, with subsequent psychologic distress, decreased empathy and worse learning outcomes. We aimed to explore resident experiences with patient death early in training, including the immediate and delayed impacts of these experiences, preparedness of trainees for these events and coping strategies used, potentially identifying gaps and opportunities to further support trainees during difficult or traumatic events. We performed a qualitative study using phenomenology methodology to understand trainees' personal experiences with patient death. Resident physicians who had completed an internal medicine rotation at McMaster University, Hamilton, Ontario, were invited to participate from December 2020 to April 2021. Semistructured interviews were conducted to understand circumstances, emotional responses, support, coping mechanisms and preparedness regarding the patient death experience. Interviews were transcribed and coded to identify emerging themes with the use of thematic and interpretive analysis. Eighteen participants were interviewed. On average, the interviews were 40 minutes in length. The participants' mean age was 27 years. The majority of trainees (10 [56%]) were in their first year of residency, with 5 (28%) from family medicine and 4 (22%) from internal medicine. Most participants (13 [72%]) had experienced their first patient death during medical school. Three themes were identified: patient death circumstances, immediate and delayed emotional impact, and preparedness and coping mechanisms. Unexpected death, pronouncing death, cardiopulmonary resuscitation and communicating with families were common challenges. Feelings of guilt, helplessness and grief followed the events. Feeling underprepared contributed to emotional consequences, including difficulties sleeping, intrusive thoughts and emotional distancing; however, these experiences were consistently normalized by participants. Patient death during medical training can be traumatic for trainees and may perpetuate loss of empathy, changes to practice and residual emotional effects. Educational initiatives to prepare trainees for patient death and teach adaptive coping strategies may help mitigate psychologic trauma and loss of empathy; further research is required to explore these strategies.

Systemic manifestation of necrotic erythema nodosum leprosum: A case report of a fatal leprosy.

Necrotic erythema nodosum leprosum (ENL) is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. Necrotic ENL is associated with the involvement of multiple organs, therefore delayed diagnosis and treatment will lead to complications and poor prognosis. The aim of this case report was to report a challenging case of necrotic ENL misdiagnosed with multiple cellulitis since there were no signs of prior leprosy nor had any antimycobacterial treatment. A 45-year-old man was presented to the surgery department of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, with complaints of fever, joint pain, and painful tender skin lesions with ulceration over the trunk, extremities, and ears for one month. The patient was diagnosed clinically with multiple cellulitis and underwent a debridement procedure. Clinical improvement was absent, the patient was then consulted to the dermatology department. Physical examination showed normal vital signs, madarosis, inguinal lymphadenopathy, thickening of nerves, and sensation of numbness in both hands and feet. Laboratory examinations on admission showed leucocytosis, anemia, thrombocytopenia, hypoalbuminemia, hypocalcemia, and elevated creatinine and ureum level. A slit skin smears examination yielded positive acid-fast bacilli (AFB) with a bacteriological index (BI) value of 3+ and morphological index (MI) of 72%. The patient was diagnosed with lepromatous leprosy with necrotic ENL reaction. Intravenous methylprednisolone and cefoperazone-sulbactam were given. Multidrug therapy mulitbacillary (MDT-MB) without dapsone, and ofloxacin 400 mg was initiated. On day 17, the patient had septic shock. The patient became unconscious and experienced death. This case highlights that medical professionals should be aware of the various manifestations of necrotic ENL to correctly diagnose and provide treatment as soon as possible to prevent mortality, especially in leprosy-endemic country, Indonesia.

Bell: A Symbol of Wholeness

This study explores the bell’s attributes as a representation of wholeness, analyzed through the lens of analytical psychology. Encompassing its production, religious significance, and literary references, our aim is to uncover the profound meaning behind the bell. The bell’s transformative journey parallels the internal struggles of individuals grappling with emerging energies while bringing unconscious thoughts into awareness. As a potent symbol, the bell possesses the unique power to bridge and harmonize opposing elements. It plays a dual role as both a religious emblem and a literary motif, embodying spirituality as a conduit for divine communication, while also safeguarding against malevolent spirits and natural perils. Additionally, it symbolizes the intricate balance between feminine and masculine forces. The resonating sound of the bell serves to awaken consciousness, initiating a cyclical process alternating between awareness and the unconscious, facilitating the experience of death and rebirth. Operating as an alarm, it illuminates existence, stirring the psyche toward an altered state of awareness and eventual conscious realization. Therefore, the bell acts as a catalyst, facilitating creative transformation that integrates disparate aspects into unity, embodying the essence of wholeness within an individual’s psyche. Through this exploration, we shed light on the bell’s pivotal role in profound psychological transformation.

Women's experiences of care after stillbirth and obstetric fistula: A phenomenological study in Kenya.

Stillbirth and (obstetric) fistula are traumatic life events, commonly experienced together following an obstructed labour in low- and middle-income countries with limited access to maternity care. Few studies have explored women's experiences of the combined trauma of stillbirth and fistula. To explore the lived experiences of women following stillbirth and fistula. Qualitative, guided by Heideggerian phenomenology. Twenty women who had experienced a stillbirth were interviewed while attending a specialist Hospital fistula service in urban Kenya. Data were analysed following Van Manen's reflexive approach. Three main themes summarised participants' experiences: 'Treated like an alien' reflected the isolation and stigma felt by women. The additive and multiplying impacts of stillbirth and fistula and the ways in which women coped with their situations were summarised in 'Shattered dreams'. The impact of beliefs and practices of women and those around them were encapsulated in 'It was not written on my forehead'. The distress women experienced following the death of a baby was intensified by the development of a fistula. Health professionals lacked an understanding of the pathophysiology and identification of fistula and its association with stillbirth. Women were isolated as they were stigmatised and blamed for both conditions. Difficulty accessing follow-up care meant that women suffered for long periods while living with a constant reminder of their baby's death. Cultural beliefs, faith and family support affected women's resilience, mental health and recovery. Specialist services, staff training and inclusive policies are needed to improve knowledge and awareness and enhance women's experiences. A Community Engagement and Involvement group of bereaved mothers with lived experience of stillbirth and neonatal death assisted with the review of the study protocol, participant-facing materials and confirmation of findings.

Midwives’ experience of maternal death

In Morocco, maternal mortality is a crucial public health problem with a current rate of 72.6/100000 live births. This phenomenon is emotionally overwhelming, and the midwife’s experience of this drama is disordering. To explore how midwives experience maternal death, the resulting consequences, and the coping strategies used to overcome it. 19 midwives were interviewed and reported 39 cases of maternal death. The results show that no midwife remains indifferent to maternal death. The experience is painful, and the grief of the families is transferred to the midwife. Sadness, denial, fear, feelings of guilt and failure have characterized almost all the victims. In the face of her suffering, the midwife mobilizes coping strategies. The consequences are diverse: psychological, somatic, and professional. The experience of maternal death associated with unfavorable working conditions and lack of recognition increases stress and leads to the intention to abandon the profession. The improvement of working conditions, the focus on teamwork, the implementation of discussion groups, professionalize the experience of maternal death.

Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study

The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant´s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.

Influencing factors of nurses’ short-term bereavement reactions after patient death

An online cross-sectional survey was performed among 181 nurses in mainland China who experienced their most recent patient death within the last month. Multivariate linear regressions were used following bivariate analysis to identify influencing factors for their short-term professional bereavement reactions. More intensive reactions were associated with the nurse’s fewer experiences of patient death; the nurse’s employment in the intensive care unit rather than the emergency, oncology, geriatrics, or internal medicine departments; and the patient experiencing more pain in the last few days. Higher reaction scores were also reported by nurses who lost the patient more than 1 week prior.

AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest

IntroductionCognitive activity and awareness during cardiac arrest (CA) are reported but ill understood. This first of a kind study examined consciousness and its underlying electrocortical biomarkers during cardiopulmonary resuscitation (CPR). MethodsIn a prospective 25-site in-hospital study, we incorporated a) independent audiovisual testing of awareness, including explicit and implicit learning using a computer and headphones, with b) continuous real-time electroencephalography(EEG) and cerebral oxygenation(rSO2) monitoring into CPR during in-hospital CA (IHCA). Survivors underwent interviews to examine for recall of awareness and cognitive experiences. A complementary cross-sectional community CA study provided added insights regarding survivors’ experiences. ResultsOf 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED) 6/28(21.4%). In the cross-sectional arm, 126 community CA survivors’ experiences reinforced these categories and identified another: delusions (misattribution of medical events). Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2 = 43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35–60 minutes into CPR. ConclusionsConsciousness. awareness and cognitive processes may occur during CA. The emergence of normal EEG may reflect a resumption of a network-level of cognitive activity, and a biomarker of consciousness, lucidity and RED (authentic “near-death” experiences).

Saturation, Meaning and Death

The demand of a moratorium on the development of AI by influential representatives of tech giants is an ambivalent sign of fear. Baudrillard’s insights on the possible end of capitalism and its regime of simulation, offers opportunities to interpret this sign as the sudden awareness, among techno-corporate elites, that AI may bring about the end of capitalism through conditions of saturation, implosion, excess. These conditions, relates to the relationship between the fear of death and the role of textual competences or ‘meaning-making’ in tackling this fear. The production of ‘meaningless meaning’ through AI textual affordances challenges the status of the text and meaning-making as humans’ atavistic response to the fear of death. As the resiliency of capitalism depends on the suppression of (the fear of) death, the development of AI textual affordances meddles with this response and with the fear it suppresses, suggesting the possibility of technological ‘indeterminism’. Through the mediation of ‘organic’ intelligence and critical knowledge, the fears about AI and the concerns about the end of capitalism by saturation can be construed as preconditions for the epistemic revaluation of the human experience of life and the fear of death against the dehumanizing effects of technological simulation of life. This paper is a preliminary, non-empirical and largely speculative or reflective engagement with three propositions about the relationship between AI textual affordances and the experience of saturation, meaning and death.

노인요양시설 이용자의 존엄한 죽음에 대한 요양보호사의 경험연구

This study aimed to analyze and interpret the meaning of dignified death for the elderly in nursing homes using phenomenological techniques for caregivers' experiences of caring practices. Two in-depth interviews were conducted with five caregivers who had worked in nursing homes for more than five years. Data were analyzed with the four stages of Giorgi's phenomenological qualitative research method. After analyzing the data, 25 meaning units, 6 sub-components, and 3 components were derived: 1) embracing death with love, with sub-components of ‘staring at death that was turned away’ and ‘facing the death of the elderly’; 2) finding meaning in the void, with sub-components of ‘experiencing the infinite in finite existence’ and ‘finding meaning that endures meaninglessness’; and 3) writing my history book in the present, with sub-components of ‘summoning the past buried in small talk’ and ‘performing a ritual of self-renewal’. This study concludes that the meaning and essence of the experience of dignified death for the elderly by caregivers who perform care work for the elderly in nursing homes are to provide opportunities for enjoyment and communication in the midst of daily life in nursing homes, to relieve the loneliness of the elderly, and to help the elderly feel satisfied with their lives in the closest place.

TERRESTRIAL SPACES AND CELESTIAL SYMBOLISM IN CEMETERIES: AN EMPIRICAL EXAMINATION OF SPACES OF THE DECEASED

The open terrestrial swathes are by far the most collaborative of spaces shared by human beings as they partake of the spatial and temporal experience. Their experiential reality is shaped by the sensory experience rooted in the physical plane of existence, palpably elusive of the metaphysical. Cemeteries however hold a unique terrestrial position as not simply seeking out open spaces on earth, but also symbolize the metaphysical experience; transcending the earthly in death. This unique ambivalence of the earthly and the celestial entrenched in the cemeteries is going to be a major concern of this research article. The article seeks to deconstruct how cemeteries which command sanctity can be powerful celestial signs in contradiction to ordinary cemeteries which however are bracketed with a relatively less celebrated and overtly mundane experience of death and Thanatos. The article will dwell into the role of select cemeteries as metaphors of power emanating from the treatment meted out to the cemeteries. The centre-periphery, life-death and celestial-terrestrial binaries will be explored through the epithets conferred upon rites of death, cemeteries and phenomena of afterlife in different cultures. Keywords: Celestial, Terrestrial, Ambivalence, Juxtaposition, Binaries, Thanatos.

Narrative Agency in Maurice Blanchot’s Récits? A Case Study on Death Sentence and Awaiting Oblivion (I)

This article investigates a type of narrative that is unacknowledged by classical narratology and hardly included in postclassical narratology studies: that of lyrical and philosophical prose, often containing elements belonging to the dramatic genre. Starting from Brian McHale’s urge to address Monika Fludernik’s exclusion of poeticity from narratology and Jan Alber’s inclusion of any poem in narrativity, I use different definitions and clarifications from classical and postclassical narratology (Vladimir Propp, Greimas, Roland Barthes, Shlomith Rimmon-Kenan, Sarah Drews Lucas, Gerald Prince, James Phelan, Peter Hühn, Jens Kiefer, Hanna Meretoja, Rachel Blau DuPlessis, John Shoptaw, Samuel Caleb Wee, Roy Sommer, Manfred Jahn, Roland Weidle), also bringing elements on agency from drama (via Martin Esslin’s notion of the “Theater of the Absurd”) in order to find the best tools to explain how Blanchot’s Death Sentence and Awaiting Oblivion elude narrative agency. On the one hand, these récits challenge the usual borders between literature and philosophy and, on the other hand, they refuse taxonomic boundaries such as what we understand by literary genres. Thus, my article focuses on the lack of narrative agency in these texts, a notion that is paradoxically connected to the affirmation of passion and passivity, which characterizes the experience of literature and death alike, often in the form of the neuter. I relate Blanchot’s neuter to Emmanuel Levinas’s il y a and I discuss the formula “X without X” as not purely privative but as a pre-critical notion which Blanchot used in order to emphasize the divide passion/passivity/action/activity. While in my discussion of Death Sentence, I define the unnarratable and the difference between the two stories that make it up, completing each other and taking the reader from the realm of life to the realm of death and back to life, in the section on Awaiting Oblivion, I deal with the philosophical language and dramatic devices of the text. With a preamble on its themes: waiting, forgetting, and speaking continuously (or “blathering”, to use Samuel Beckett’s term), I finally put Awaiting Oblivion in relation to Beckett’s Waiting for Godot.

One Ring to Bring Them Both and in the Darkness Bind Them: The Shire as Frodo Baggins’s Topographical Equivalent

This paper deals with the problem of identity and place in J. R. R. Tolkien’s The Lord of the Rings. It attempts to show that the main character’s connection with his homeland is deeper yet than what is usually perceived. When comparing Frodo’s journey and the Shire’s development throughout the novel it is possible to see many coincidences in their paths. As a result, we may state that the Shire mirrors Frodo’s evolution. This curious discovery prompted the creation of the term “topographical equivalent” to describe their unique relationship. This, in turn, affects the hero’s journey, for when he reaches the Shire’s doppleganger, the land of Mordor, he is also facing his own. This encounter not only affects Frodo as a near death experience. It results in a painful extension of consciousness too, since the world is capable of containing an evil so opposite to his and his homeland’s natures. A change is produced from a local conception of place to a broader one of space. Both these traumatic events alter the hero. Furthermore, these consequences become quite revealing when trying to decipher Frodo’s strange relationship and final abandonment of the Shire after the Quest of the Ring is over.

A History and Experience of Bloomsday in Lisbon 2012-2022

This text is an account of “Bloomsday”(a celebration of the day in which James Joyce’s Ulysses is set) in Lisbon in the years 2012-2022, from the perspective of the director of the event. I have always tried to interweave Ireland, Portugal and Brazil in the encounter with Joyce with ourselves and our sounds in language and music, with our diverse locations, and with the different translations of Ulysses. The vision has always been to combine entertainment and a subversive joy via music, performative readings and remarks on Ulysses, together with diving deep into the philosophical panorama and profound possibilities of experimenting with language through everyday characters and the experience of life and death within a simple story that encompasses Joyce’s “chaosmos.” Crucially, it is in reading and hearing the text aloud where one enters literature as reality and as a vivid experience. This text also brings up two fascinating reviews of Ulysses which were an inspiration for Bloomsday in 2022: one from 1922 by Shane Leslie (the son of a protestant Anglo-Irish landlord, who converted to Catholicism) where he referred to the book as “literary Bolshevism”; and the other from 1935 by Karl Radek (a Bolshevik leader of the Russian Revolution of 1917) who called it “a heap of dung, crawling with worms.” In their negative critique from opposite ends of the political spectrum, they nevertheless capture the revolutionary spirit and “epic of the human body” of the book in which we are still learning to catch up with and to flourish.

First death experiences of newly graduated nurses: A qualitative phenomenological study

Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.

Death, dying and caring: exploring the student nurse experience of palliative and end-of-life education

Background: Undergraduate education and training are fundamental in preparing student nurses for working in palliative and end-of-life care. Aim: This article explores the experiences of student nurses in their palliative and end-of-life undergraduate nurse education. Methodology: Sandelowski and Barroso's (2007) framework for undertaking a metasynthesis was used. Initial database searches returned 60 articles of interest. Re-reading the articles in the context of the research question identified 10 studies that met the inclusion criteria. Four key themes emerged. Findings: Student nurses voiced concerns regarding their feelings of unpreparedness, and lack of confidence and knowledge when dealing with the complexities of palliative and end-of-life care. Student nurses called for more training and education in palliative and end-of-life care. Conclusion: Flexible nursing curricula responsive to the needs of student nurses and the changing landscape of healthcare provision, including care to ensure a good death experience, should be prioritised at undergraduate level.

Gonadal Degeneration Is Mediated by Apoptotic Processes in the Semelparous Gray Side-Gilled Sea Slug Pleurobranchaea maculata.

AbstractSpecies undergoing postreproductive death experience great changes in their reproductive organs, which are driven by numerous physiological processes. To assess whether apoptotic processes are involved in the dynamics of the reproductive organs of Pleurobranchaea maculata, the gonadal structure of this semelparous side-gilled sea slug was studied using light and scanning electron microscopy. Apoptotic cells at different gonadal developmental stages were detected by in situ TUNEL assay. Apoptosis was primarily focused on spermatogonia during gonadal cell proliferation, probably as a regulatory mechanism that maintains homeostasis in reproductive cells. Visible gonadal degeneration at the end of the reproductive period is accompanied by apoptosis of the basal lamina cells of the acini, suggesting that apoptotic processes are involved in the gonadal degeneration observed in P. maculata.

AFROFUTURISM AND BLACK UTOPIA IN BRAZILIAN (POST)MODERNITY

Disenchanting realities of black life in Brazil often compel writers such as Aline França, Ana Paula Maia, and Elisa Lucinda, among others, to opt for radical magical realism as a coping strategy. By embracing Afrofuturism and utopia, the daily existential experiences of oppression, repression, violence, brutality, and social death are subverted through the creative imagination. Despite these traumatic conditions of dehumanization, the three writers find consolatory outlets in fantasy and science fiction as in A Mulher de Aleduma [Woman of Aleduma] (1981) by Aline França; bestification and apocalyptical allusions of the trilogy in Saga of Brutes (2016), De Gados e Homens [On Cattles and Men] (2013), Enterre Seus Mortos [Bury Your Dead] (2018), and Assim na Terra como Embaixo da Terra [Same on Earth as it is Under the Earth] (2020) by Ana Paula Maia; and compassion within nihilism as in Vozes Guardadas [Voices Kept] (2016) and Fernando Pessoa: o Cavaleiro de Nada [Fernando Pessoa: The Horseman of Nothingness] (2015) by Elisa Lucinda. Anchored on the creative power of innovative cultural mythmaking, each writer creates protagonists that are partly human, partly bestial, and partly divine in order to evoke their anti-heroic qualities as essential characteristics for their transcendence. In addition, the heroic protagonists of these writers are endowed with supernatural powers that lend credence to their ritual provenance from the labyrinth of myth and history in order to teach eternal morals. Through the prism of the mythic transformation of reality, as embodied in França’s protagonist, Aleduma, the imagined planet of Ignum sings as if to recuperate Africa’s religious values and glories: “The waters of Oxalá / Will wash my head / The children of Africa / Are coming to look for me. / I am going, I am going to Africa to dance / To my father Oxalá.” Beyond this celebratory yet romantic ancestral connection with Africa, the transitory nature of life as tragically and apocalyptically presented by the narrator in one of Maia’s narratives, especially Carvão Animal [Animal Char], where soil and water are contaminated by the toxic liquid draining from human bodies in decomposition, appeals to our sense of human indignation in the face of horror: “Some decades or centuries from now there will be more bodies beneath the earth than on it. We’ll be stepping on our ancestors, neighbors, relatives, and enemies, as we step on dry grass: without even noticing it.” Finally, when absurdity seems to have lost all of its potential to shock, Lucinda finds compelling inspiration not in the Afro-Brazilian condition, but in the classic personality of multifaceted Fernando Pessoa for whom according to Mia Couto, audacity can compel us to “write like someone who is feverish, and who comes close to the fire in order to engulf himself with its warmth.” Through the cogent lenses of these cursory snippets of existential realities, I argue that the three Afro-Brazilian women writers under analysis in this chapter, strike a common chord with estranging absurdities of the human condition, while their works seek to transcend that estranging and alienating condition through creative escapism.

Perspectives of nursing students on end-of-life nurse education: A qualitative study of the guided death experience

BackgroundAlthough various studies reported on educational methods for end-of-life care, there is lack of evidence on how nursing students experience simulated death. ObjectivesThis study explored the experiences of undergraduate nursing students who participated in a guided death experience. DesignThe research utilized a qualitative descriptive design. SettingsThe research was conducted at a Japanese university nursing school. ParticipantsA total of 82 nursing students were recruited to complete an end-of-life course in which they participated in a guided death experience as part of their third-year curriculum. MethodsDescriptions of the guided death experience were analyzed using content analysis. ResultsNursing students' experiences in the guided death experience fell into two main categories: “subjective experience of immersing oneself in the world of the patient who is dying” and “formation of nursing perspectives of end-of-life care.” The former focused on subjective experiences of nursing students vividly expressing their own emotions such as grief, anger, fear, and depression during the guided death experience process. The latter expressed recognition of the essence of end-of-life-care through the guided death experience, such as thinking about needs of the person who is dying, being present, and listening to the individual. ConclusionsIn end-of-life nurse education, the guided death experience allows students to face first-person death. This fosters a core view of nursing in palliative and end-of-life care. Overall, the guided death experience is an important means of preparatory education for relevant clinical practice.

Nursing Students' Spiritual/Religious Coping Strategies Dealing With First Experience of Witnessing Death During Clinical Practices.

This study aims at determining spiritual/religious coping strategies of nursing students dealing with the first experience of witnessing death during clinical practices. One of the qualitative research approaches, a descriptive phenomenological study was designed. The study was carried out with 14 nursing students studying at a state university in Turkey. The students' first experiences of witnessing death were examined by the personal in-depth interviewing method. Data were analyzed using the thematic analysis method. The following five main themes were identified by the analysis: Perception of death; Witnessing death for the first time; Coping with death experience; Needs and recommendations; Impact of spirituality and religion. The obtained findings were presented according to the COREQ criteria. The findings showed that witnessing death for the first time is a difficult experience that affects students in various ways and students prayed and performed their prayers frequently to cope with the death experience.